title: Lung cancer and vehicle exhaust in trucking industry workers.
abstract: BACKGROUND
  An elevated risk of lung cancer in truck drivers has been attributed to diesel exhaust exposure. Interpretation of these studies specifically implicating diesel exhaust as a carcinogen has been limited because of limited exposure measurements and lack of work records relating job title to exposure-related job duties.
  
  
  OBJECTIVE
  We established a large retrospective cohort of trucking company workers to assess the association of lung cancer mortality and measures of vehicle exhaust exposure.
  
  
  METHODS
  Work records were obtained for 31,135 male workers employed in the unionized U.S. trucking industry in 1985. We assessed lung cancer mortality through 2000 using the National Death Index, and we used an industrial hygiene review and current exposure measurements to identify jobs associated with current and historical use of diesel-, gas-, and propane-powered vehicles. We indirectly adjusted for cigarette smoking based on an industry survey.
  
  
  RESULTS
  Adjusting for age and a healthy-worker survivor effect, lung cancer hazard ratios were elevated in workers with jobs associated with regular exposure to vehicle exhaust. Mortality risk increased linearly with years of employment and was similar across job categories despite different current and historical patterns of exhaust-related particulate matter from diesel trucks, city and highway traffic, and loading dock operations. Smoking behavior did not explain variations in lung cancer risk.
  
  
  CONCLUSIONS
  Trucking industry workers who have had regular exposure to vehicle exhaust from diesel and other types of vehicles on highways, city streets, and loading docks have an elevated risk of lung cancer with increasing years of work.
authors.affiliation: Pulmonary and Critical Care Medicine Section, Medical Service, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA. eric.garshick@va.gov
authors.forename: Eric
authors.initials: E
authors.lastname: Garshick
authors.forename: Francine
authors.initials: F
authors.lastname: Laden
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Hart
authors.forename: Bernard
authors.initials: B
authors.lastname: Rosner
authors.forename: Mary E
authors.initials: ME
authors.lastname: Davis
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Eisen
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012907:Smoking; D014186:Transportation; D014481:United States; D001335:Vehicle Emissions / Q000633:toxicity*
chemical_list: D001335:Vehicle Emissions